What Is a Peritonsillar Abscess?

A peritonsillar abscess is an area of pus-filled tissue at the back of the mouth, next to one of the tonsils. The abscess can be very painful and can make it difficult to open the mouth. It can also cause swelling that may push a person's tonsil toward the uvula (the dangling fleshy object at the back of the mouth). If this happens, it can become hard to swallow, speak, and maybe even breathe.

If you think you have an abscess in the back of your throat, you'll want to see a doctor. If a peritonsillar abscess isn't treated, it can lead to more serious health problems.

What Causes Peritonsillar Abscesses?

Peritonsillar abscesses are most often caused by a type of bacteria called group A beta-hemolytic streptococci — the bacteria that cause strep throat. Sometimes other types of bacteria are involved as well.

Peritonsillar abscesses usually happen as a complication of tonsillitis. If the infection breaks out of a tonsil and gets into the space surrounding it, an abscess can form. Luckily, peritonsillar abscesses aren't that common these days because doctors use antibiotics to treat tonsillitis.

Tooth and gum disease can increase the chances of a peritonsillar abscess forming, as can smoking — more good reasons to brush your teeth and avoid cigarettes.

What Are the Signs Someone Has It?

Often the first sign of a peritonsillar abscess is a sore throat. As the abscess develops, other symptoms will start to appear. Some of the most common ones include:

red, swollen tonsils

a tonsil that's pushing against the uvula

tender, swollen glands (lymph nodes) on one side of the neck

severe pain on one side of the throat

difficulty and pain when swallowing or opening the mouth

fever and chills

headache

earache

drooling

a muffled or hoarse voice

A peritonsillar abscess that goes untreated for a long period of time can lead to serious complications —for example, the infection may extend into the jaw, neck, and chest, or someone might develop pneumonia.

What Should You Do?

Call your doctor if you have a sore throat with a fever or any of the other problems that can be caused by a peritonsillar abscess. It's rare that a peritonsillar abscess will get in the way of your breathing, but if it does, you may need to go to the emergency room right away.

What Do Doctors Do?

The doctor will examine your mouth, throat and neck. He or she also may take a throat culture and a blood test. On rare occasions, a doctor may order a CT scan or ultrasound.

The usual treatment for a peritonsillar abscess involves having a doctor drain the abscess. The doctor does this either by withdrawing the pus with a needle (called aspiration) or making a small cut in the abscess with a scalpel so the pus can drain out.

If this doesn't work, a patient may need to have his or her tonsils removed, which is done by a procedure called a tonsillectomy. This is especially true for people who have had tonsillitis a lot or who have had a peritonsillar abscess in the past.

If it's hard to eat or drink, patients may need intravenous fluids for hydration. A doctor will also prescribe painkillers and antibiotics. Whenever you take antibiotics, always finish the full course of medication — even if you feel better after a few days.

People who are treated with aspiration or tonsillectomy may need to stay in the hospital. That way doctors can keep an eye on them to make sure everything went as planned.

Can Peritonsillar Abscess Be Prevented?

You can take a few precautions to lower your risk of getting an abscess in your tonsils — like not smoking and making sure you keep your teeth and mouth clean.

But sometimes a peritonsillar abscess is beyond your control. If you suspect you have an abscess, call your doctor right away. The earlier a doctor diagnoses it, the less involved the treatment is likely to be.